Medicine & USMLE

Lamotrigine

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Antiseizure Drugs
  1. Ethosuximide
  2. Gabapentinoids
  3. Levetiracetam
  4. Lamotrigine
  5. Valproic Acid
  6. Phenytoin
  7. Carbamazepine
  8. Oxcarbazepine
  9. Topiramate
  10. Lamotrigine
  11. Phenytoin (Old)
  12. Carbamazepine (Old)
  13. Levetiracetam (Old)
  14. Valproic Acid (Old)

Summary

Lamotrigine is a drug that works by blocking sodium channels.

Clinically, it is used as a broad spectrum antiepileptic drug, meaning it can treat both generalized and focal seizures. In addition to seizures, lamotrigine is also used as a mood stabilizer to treat bipolar disorder.

Lamotrigine can cause several side effects, including sedation, headache, dizziness, and diplopia. Skin-related reactions, such as rash, Stevens-Johnson Syndrome, and DRESS syndrome, are also possible. Many patients may also experience nausea and vomiting. Lastly, lamotrigine may cause an increased risk of suicidal thoughts and behaviors.

Key Points

  • Lamotrigine
    • Mechanism
      • Blocks Na+ channels
        • Because Na+ channels are used for most neural action potentials, this can suppress neuronal activations, leading to broad-spectrum antiepileptic effects
    • Clinical Use
      • Treats seizures (antiepileptic)
        • Broad-spectrum
          • Treats partial (focal) seizures
          • Treats generalized (tonic-clonic) seizures
      • Treats bipolar disorder
        • Mood stabilizer
        • Particularly useful for treating depressed phase
    • Side Effects
      • Sedation
      • Dizziness
      • Rash
      • Headache
      • Nausea/vomiting
      • Diplopia
      • DRESS
      • Steven Johnson Syndrome (SJS)
        • Drug-induced skin and mucosal reaction that may lead to necrosis and peeling
        • Dose-limiting and relatively common; dose must be titrated slowly
      • May increase suicide risk